About the Program

The Nephrology fellowship is a certified, 2-year program that trains
graduates of A.B.I.M. accredited medical residencies. There
are five positions, with two or three fellows accepted in
alternating years.

The Division of Nephrology at NYHQ offers an accredited two year
clinical fellowship program designed to train qualified candidates to
become specialty consultants in Nephrology. The program provides an
in-depth exposure to clinical nephrology and extra-corporeal treatments
in both in-patient, critical care and out-patient settings. Fellows
receive training in transplantation and clinical research as well.

The Nephrology training program is composed of inpatient and ambulatory
training. The inpatient nephrology service at NYHQ is divided into three
rotations that provide dialytic, consultative and primary care
experience. The fellow rotates on each service, each for one month
intervals, for a total inpatient experience of 6 months per year.

The patient population differs on the three rotations but in total
comprise private and non-private renal consultations and primary care
nephrology and dialysis patients on the medical and surgical services as
well as in the intensive care units. The fellow gains experience in
critical care nephrologic problems, electrolyte and acid-base disorders,
acute and chronic renal diseases, hypertensive emergencies, ESRD patient
complications and all forms or dialysis and other extra-corporeal
treatments. The fellow functions as an consultant and primary care
physician for renal patients under the guidance and supervision of a
board certified rounding nephrologist. The renal fellow closely
interacts with other services such as surgery, interventional radiology
and pathology during these rotations. The renal fellow functions as a
junior attending while rotating on the renal floor, where the majority
of nephrologic patients are admitted. The fellow guides the care of the
medical residents assigned to the renal floor service as well as the
residents rotating on the renal elective.

The fellow directs the management of the consultations, supervises the
residents patient care, and plays an active role in educating the
medical housestaff. During these inpatient rotations the fellow also
cares for patients in the inpatient dialysis unit. The fellow is
responsible for writing dialysis prescriptions, dialysis scheduling and
caring for the dialytic and medical issues that arise. Daily rounds with
an assigned attending occurs 6 days a week. The sessions are divided
into patient care work rounds as well as informal teaching sessions on
selected topics guided by the cases presented. The fellow will gain
expertise for a variety of nephrologic skills during these rotations. An
attending is always available for supervision and training of all
procedures such as placement of central dialysis catheters, renal
biopsies, bone biopsies, placement of acute peritoneal catheters,
dialysis and extra-corporeal procedures, and plasma pheresis.

The outpatient experience occurs at the Trude Weishaupt Satellite
Dialysis Center where 224 hemodialysis patients and 45 peritoneal
dialysis patients are treated in a state of the art facility. During
this rotation, for 5 months per year, the trainee gains experience in
outpatient hemodialysis and perititoneal dialysis patient care. The
trainee also becomes familiar with the water treatment systems, dialysis
equipment, and ESRD regulations and requirements. The trainee
participates in interdisciplinary patient care meetings and CQI
conferences. The fellow gains further ambulatory nephrology experience
by participating in several ambulatory care sessions:

Throughout both years the fellow attends weekly renal and HTN
clinics where he/she cares for a panel of patients.

During the outpatient experience the fellow attends CAPD
dialysis clinics twice per week.

Throughout the training program the fellow attends weekly
faculty practice office hours where the trainee follows a panel
of chronic transplant patients and patients with other
hypertensive/nephrologic issues.

During the outpatient experience, the fellow attends geriatric
rounds with an attending at Silvercrest Nursing Home.

The trainee is also encouraged to participate in lithotripsy
sessions at NYHQ under the guidance of the Urology faculty.

The renal fellow is encouraged to achieve a level of independent
thinking and patient care deliverance during the training program. They
are given increased responsibility proportional to their level of
training and expertise achieved. A second year fellow will supervise and
assist in technical training of a first year trainee, is responsible for
several program administrative duties and is expected to actively
participate in delivering lectures to the medical housestaff.

During training the renal fellow rotates for 2 months on the inpatient
transplant service at NYP-Cornell Rogosin Institute transplant service.
During this rotation the fellow is exposed to newly transplanted
patients and chronic transplanted patients admitted with medical,
surgical or immunologic complications. The fellows participates in daily
rounds and patient care, attends outpatient transplant clinics and
transplant conferences. This rotation is designed to educate the trainee
on pre-operative transplant evaluation, peri-operative and
post-operative patient care and the use of immunosuppressant agents in
the treatment of acute and chronic rejection.

All fellows are required to participate in at least one clinical
research project and QAP project. Specific time is allotted during
outpatient and inpatient rotations for the fellow to complete their
assigned projects. The fellow is assigned a faculty member as a research
preceptor.

The fellow work week is restricted to less than 80 hours which includes
"internal moonlighting" opportunities in the satellite dialysis unit.
The daily work hours is from 7:30-8am to 5-6 PM. The fellow is on call
one weekend out of 5 and 1 night per week. The fellow takes call at home
on nights and weekends. Vacation time is one month per year.

On-call

Offsite, one night per week plus every fifth weekend.

Fellowship Strengths

The Nephrology Fellowship Program offers a diverse educational
experience. The trainees are taught by a distinguished and committed
on-site faculty that have been rated as excellent teachers by the
medical students and residents of the institution. The residents are
exposed to a large and diverse patient population that present with
diseases that span the entire spectrum of nephrology. The training
includes a strong ambulatory, inpatient and critical care experience.
The fellows have the opportunity to become adept in all nephrologic
procedures. The program also offers state of the art facilities in
dialysis, clinical services and computerized educational programs. The
fellows have the opportunity to participate in several local and
national conferences per year as well as the exposure to many guest
lecturers which broaden their educational experience.

Application

The Nephrology fellowship at NYHQ particpates in a Nephrology match.
Applicants must meet the following criteria:

American Citizenship or Permanent Residency.

Completion of a 3 year accredited internal medicine program in
the United States.

Board Certification in Internal Medicine, if applicable.

Above average USMLE scores and performance record from their
medical training program.